Challenging Pain

Simon Thorp

Living with constant pain is a struggle, both physically and emotionally. If you have pain that just refuses to go away, it may be time to see a pain specialist, says Dr Simon Thorp.

“Pain is something we all experience from time to time – we fall ill, hurt ourselves and sometimes have aches and pains for no apparent reason. It’s an indication that something is not quite right in our body and can protect us from doing further damage. In most cases, the painful symptoms either go away by themselves or can be resolved quickly and easily by your GP. But occasionally, the pain just won’t go away no matter what you do and in this instance, your doctor may refer you to a pain specialist.

“Pain specialists are consultants in pain medicine and are usually also anaesthetists. They are experienced in helping patients who suffer from stubborn pain no matter what the cause. Common conditions are back and joint pain, neuralgia – a sharp shocking pain that follows the path of a nerve - and pain that persists after surgery.

What treatments are available?

“A pain specialist will be able to recommend the best approach to managing your pain. They will review any drugs that you are currently taking and identify the most effective ones for your type of pain. They may also tailor-make you a mixture of drugs which, when taken together, have a far greater effect than simply taking painkillers on their own.

“In recent years there have been many advances in drugs that provide pain relief. One notable example is a substance called capsaicin, which is in fact the hot part of a chilli pepper. When formulated into a cream or medicated plaster, it has been found to be particularly effective in treating joint pain, neuralgias and painful peripheral neuropathies (pain caused by nerve damage).

Are drugs the only option?

“As well as fine-tuning your medicine, your pain specialist may suggest other forms of treatment such as physiotherapy. There are also more targeted procedures which act directly on the area that is causing the pain, such as injecting directly into the culprit nerve or joint or, in particularly stubborn cases, destroying the problem nerve.

Is pain just a physical symptom?

“Living with persistent pain can take its toll emotionally as well as physically and it is quite common for patients to suffer from depression and feelings of isolation. In many cases the pain specialist will call upon a psychologist trained in pain to help treat the emotional component of the patient’s symptoms.

If you would like further information, I strongly recommend a booklet called Understanding and Managing Pain: Information for Patients published by the British Pain Society www.britishpainsociety.org.uk .If you suffer from chronic pain and think a pain consultant might be able to help, you can ask your GP for a referral.”